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<body class="ares-p">
<div class="print-div">

    <div style="text-align: center;display: none;" class="print print-title" id="print-title">病历记录</div>

    <h3>基本信息</h3>
    <div class="ares-mb layui-form" lay-filter="base-info">
        <div class="emr-info"></div>
        <div class="ares-mt">
            <div class="layui-inline ares-mb ares-mr-lg">
                <label>患者类别<i class="ares-text-red">*</i></label>
                <div class="layui-input-inline">
                    <select id="patient-type" name="patientType" lay-filter="patient-type">
                        <option value="1">门诊患者</option>
                        <option value="2">住院患者</option>
                        <option value="3">会诊患者</option>
                    </select>
                </div>
            </div>
            <div class="layui-inline ares-mb ares-mr-lg">
                <label>患者编号<i class="ares-text-red">*</i></label>
                <div class="layui-input-inline">
                    <input id="emr-number" name="emrNumber" required placeholder="请输入门诊号|住院号" class="layui-input">
                </div>
            </div>
            <div id="area-bed-wrap" class="layui-inline layui-hide ares-mb">
                <label>病区/病床<i class="ares-text-red">*</i></label>
                <div class="layui-input-inline">
                    <input id="ward-area" name="wardArea" placeholder="请输入病区" class="layui-input">
                </div>
                <div class="layui-input-inline">
                    <input id="bed-number" name="bedNumber" placeholder="请输入病床" class="layui-input">
                </div>
            </div>
        </div>
    </div>

    <h3>病历记录</h3>
    <div class="layui-tab layui-tab-card" lay-filter="type">
        <ul class="layui-tab-title">
            <li class="layui-this" lay-id="2">中风</li>
            <li lay-id="3">腰痛</li>
            <li lay-id="4">膝关节僵硬</li>
            <li lay-id="5">脊髓损伤</li>
            <li lay-id="1">脑性瘫痪</li>
        </ul>
        <div class="layui-tab-content">
            <div id="stroke" class="layui-tab-item layui-show">
                <form class="ares-p layui-form" lay-filter="stroke">
                    <div class="layui-form-item">
                        <label class="layui-form-label"><span class="ares-text-red">*</span>主诉</label>
                        <div class="layui-input-block">
                            <textarea name="1-0-0" lay-verify="required" placeholder="请输入主诉" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label"><span class="ares-text-red">*</span>现病史</label>
                        <div class="layui-input-block">
                            <textarea name="1-1-0" lay-verify="required" placeholder="请输入现病史" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">一般情况</label>
                        <div class="layui-input-block ares-row">
                            <div class="ares-col-sm-12 ares-col-md-6">
                                <label class="prefix-label inline-label">体温</label>
                                <input type="number" name="1-2-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">℃</label>
                            </div>
                            <div class="lares-col-sm-12 ares-col-md-6">
                                <label class="prefix-label inline-label">脉搏</label>
                                <input type="number" name="1-3-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">次/分</label>
                            </div>
                            <div class="ares-col-sm-12 ares-col-md-6">
                                <label class="prefix-label inline-label">呼吸</label>
                                <input type="number" name="1-4-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">次/分</label>
                            </div>
                            <div class="ares-col-sm-12 ares-col-md-6">
                                <label class="prefix-label inline-label">血压</label>
                                <input type="number" name="1-5-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">/</label>
                                <input type="number" name="1-6-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">mmHg</label>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">危险因素、既往史</label>
                        <div class="layui-input-block">
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-7-0" title="高血压">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-7-1" title="高血脂">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-7-2" title="糖尿病">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-7-3" title="房颤">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-7-4" title="吸烟史">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-7-5" title="TIA病史">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-7-6" title="脑卒中病史">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-7-7" title="心肌梗死病史">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-7-8" title="其它血栓性事件">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-7-9" title="肥胖">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-7-10" title="酗酒史">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-7-11" title="颈动脉狭窄病史">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-7-12" title="其它疾病">
                                </div>
                            </div>
                            <textarea name="1-7-12-text" placeholder="请输入危险因素、既往史其它补充内容" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">药物治疗情况</label>
                        <div class="layui-input-block">
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-8-0" title="降血压">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-8-1" title="神经保护剂">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-8-2" title="血糖控制">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-8-3" title="镇静剂">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-8-4" title="调节血脂">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-8-5" title="抗癫痫">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-8-5" title="抗癫痫">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-8-6" title="抗血小板">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="1-8-7" title="其它">
                                </div>
                            </div>
                            <textarea name="1-8-7-text" placeholder="请输入药物治疗情况其它补充内容" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">专科检查</label>
                        <div class="layui-input-block">
                            <label class="inline-label">肌力</label>
                            <textarea name="1-9-0" placeholder="" class="layui-textarea"></textarea>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-checkbox-label">关节活动范围</label>
                            <input type="checkbox" lay-skin="primary" name="1-10-0" title="各关节被动ROM未及明显异常">
                            <textarea name="1-10-0-text" placeholder="" class="layui-textarea"></textarea>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-checkbox-label">Brunnstrom分期</label>
                            <div>
                                <div class="layui-inline">
                                    <label class="inline-label">左上肢</label>
                                    <div class="layui-inline">
                                        <select name="1-11-0">
                                            <option value="">请选择</option>
                                            <option value="1">Ⅰ期</option>
                                            <option value="2">Ⅱ期</option>
                                            <option value="3">Ⅲ期</option>
                                            <option value="4">Ⅳ期</option>
                                            <option value="5">Ⅴ期</option>
                                            <option value="6">Ⅵ期</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="layui-inline">
                                    <label class="inline-label">左手部</label>
                                    <div class="layui-inline">
                                        <select name="1-12-0">
                                            <option value="">请选择</option>
                                            <option value="1">Ⅰ期</option>
                                            <option value="2">Ⅱ期</option>
                                            <option value="3">Ⅲ期</option>
                                            <option value="4">Ⅳ期</option>
                                            <option value="5">Ⅴ期</option>
                                            <option value="6">Ⅵ期</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="layui-inline">
                                    <label class="inline-label">左下肢</label>
                                    <div class="layui-inline">
                                        <select name="1-13-0">
                                            <option value="">请选择</option>
                                            <option value="1">Ⅰ期</option>
                                            <option value="2">Ⅱ期</option>
                                            <option value="3">Ⅲ期</option>
                                            <option value="4">Ⅳ期</option>
                                            <option value="5">Ⅴ期</option>
                                            <option value="6">Ⅵ期</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="layui-inline">
                                    <label class="inline-label">右上肢</label>
                                    <div class="layui-inline">
                                        <select name="1-14-0">
                                            <option value="">请选择</option>
                                            <option value="1">Ⅰ期</option>
                                            <option value="2">Ⅱ期</option>
                                            <option value="3">Ⅲ期</option>
                                            <option value="4">Ⅳ期</option>
                                            <option value="5">Ⅴ期</option>
                                            <option value="6">Ⅵ期</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="layui-inline">
                                    <label class="inline-label">右手部</label>
                                    <div class="layui-inline">
                                        <select name="1-15-0">
                                            <option value="">请选择</option>
                                            <option value="1">Ⅰ期</option>
                                            <option value="2">Ⅱ期</option>
                                            <option value="3">Ⅲ期</option>
                                            <option value="4">Ⅳ期</option>
                                            <option value="5">Ⅴ期</option>
                                            <option value="6">Ⅵ期</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="layui-inline">
                                    <label class="inline-label">右下肢</label>
                                    <div class="layui-inline">
                                        <select name="1-16-0">
                                            <option value="">请选择</option>
                                            <option value="1">Ⅰ期</option>
                                            <option value="2">Ⅱ期</option>
                                            <option value="3">Ⅲ期</option>
                                            <option value="4">Ⅳ期</option>
                                            <option value="5">Ⅴ期</option>
                                            <option value="6">Ⅵ期</option>
                                        </select>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-checkbox-label">平衡功能</label>
                            <div>
                                <div class="layui-inline">
                                    <label class="inline-label">坐位平衡</label>
                                    <div class="layui-inline">
                                        <select name="1-17-0">
                                            <option value="">请选择</option>
                                            <option value="1">1级</option>
                                            <option value="2">2级</option>
                                            <option value="3">3级</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="layui-inline">
                                    <label class="inline-label">站立平衡</label>
                                    <div class="layui-inline">
                                        <select name="1-18-0">
                                            <option value="">请选择</option>
                                            <option value="1">1级</option>
                                            <option value="2">2级</option>
                                            <option value="3">3级</option>
                                        </select>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-label"><span class="ares-text-res">*</span>ADL评分(改良Barthel指数)</label>
                            <input type="number" name="1-19-0" autocomplete="off" lay-verify="required|number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                            <label class="inline-label">分</label>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-label">认知功能</label>
                            <textarea name="1-20-0" placeholder="" class="layui-textarea"></textarea>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-label">言语</label>
                            <textarea name="1-21-0" placeholder="" class="layui-textarea"></textarea>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-label">吞咽</label>
                            <textarea name="1-22-0" placeholder="" class="layui-textarea"></textarea>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-label">浅/深感觉</label>
                            <textarea name="1-23-0" placeholder="" class="layui-textarea"></textarea>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-label">病理征</label>
                            <textarea name="1-24-0" placeholder="" class="layui-textarea"></textarea>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-label">其它</label>
                            <textarea name="1-25-0" placeholder="" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">临床诊断</label>
                        <div class="layui-inline">
                            <label class="inline-label">西医诊断</label>
                            <div class="layui-inline">
                                <select name="1-26-0">
                                    <option value="">请选择</option>
                                    <option value="1">脑梗死</option>
                                    <option value="2">椎动脉栓塞脑梗死</option>
                                    <option value="3">颈动脉血栓形成脑梗死</option>
                                    <option value="4">基底动脉栓塞脑梗死</option>
                                    <option value="5">大脑动脉血栓形成脑梗死</option>
                                    <option value="6">脑梗死后遗症</option>
                                    <option value="7">丘脑梗死</option>
                                    <option value="8">腔隙性脑梗死</option>
                                    <option value="9">多发性脑梗死</option>
                                    <option value="10">基底节动脉血栓脑梗死</option>
                                    <option value="11">基底节脑梗死</option>
                                    <option value="12">脑出血</option>
                                    <option value="13">间脑出血</option>
                                    <option value="14">丘脑出血</option>
                                    <option value="15">脑出血后遗症</option>
                                    <option value="16">小脑出血</option>
                                    <option value="17">多发性脑出血</option>
                                    <option value="18">高血压脑出血</option>
                                    <option value="19">创伤性脑出血</option>
                                    <option value="20">其它</option>
                                </select>
                            </div>
                        </div>
                        <div class="layui-inline">
                            <label class="inline-label">中医诊断</label>
                            <div class="layui-inline">
                                <select name="1-27-0">
                                    <option value="">请选择</option>
                                    <option value="1">中风病(肝阳暴亢、风火上扰)</option>
                                    <option value="2">中风病(风瘫瘀血、痹阻脉络)</option>
                                    <option value="3">中风病(痰热腑实、风痰上扰)</option>
                                    <option value="4">中风病(气虚血瘀)</option>
                                    <option value="5">中风病(阴虚风动)</option>
                                </select>
                            </div>
                        </div>
                        <div class="layui-inline">
                            <label class="inline-label">功能诊断</label>
                            <div class="layui-inline">
                                <select name="1-28-0">
                                    <option value="">请选择</option>
                                    <option value="1">肌力功能障碍</option>
                                    <option value="2">肌张力功能障碍</option>
                                    <option value="3">关节活动度功能障碍</option>
                                    <option value="4">平衡功能</option>
                                    <option value="5">言语功能障碍</option>
                                    <option value="6">感觉功能障碍</option>
                                    <option value="7">认知障碍</option>
                                    <option value="8">ADL功能障碍</option>
                                    <option value="9">步行功能障碍</option>
                                    <option value="10">吞咽功能障碍</option>
                                </select>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-label">补充说明</label>
                            <textarea name="1-29-0" placeholder="" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <div class="layui-input-block">
                            <button class="layui-btn layui-hide" data-type="2" lay-submit lay-filter="submit-stroke">提交表单</button>
                        </div>
                    </div>
                </form>
            </div>
            <div id="osphyalgia" class="layui-tab-item">
                <form class="ares-p layui-form" lay-filter="osphyalgia">
                    <div class="layui-form-item">
                        <label class="layui-form-label"><span class="ares-text-red">*</span>主诉</label>
                        <div class="layui-input-block">
                            <textarea name="2-0-0" lay-verify="required" placeholder="请输入主诉" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label"><span class="ares-text-red">*</span>现病史</label>
                        <div class="layui-input-block">
                            <textarea name="2-1-0" lay-verify="required" placeholder="请输入现病史" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label"><span class="ares-text-red">*</span>疼痛评定VAS</label>
                        <div class="layui-input-block">
                            <div class="layui-inline">
                                <input type="number" id="slider_result" name="2-2-0" autocomplete="off" lay-verify="required|number|range" lay-verType="tips" min="0" max="100" readonly
                                       class="layui-input inline-input">
                            </div>
                            <div class="layui-inline">
                                <input type="range" name="2-3-0" max="100" min="0" step="1"
                                       onchange="$('#slider_result').val($(this).val());"
                                       oninput="$('#slider_result').val($(this).val());">
                            </div>
                            <div class="layui-inline ares-text-xs">提示：无痛(0)到剧痛(100)</div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">一般情况</label>
                        <div class="layui-input-block ares-row">
                            <div class="ares-col-6">
                                <label class="inline-label">身高</label>
                                <input type="number" name="2-4-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">cm</label>
                            </div>
                            <div class="ares-col-6">
                                <label class="inline-label">体重</label>
                                <input type="number" name="2-5-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">kg</label>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">外伤史</label>
                            <input type="radio" name="2-6-0" value="0" title="有">
                            <input type="radio" name="2-6-0" value="1" title="无" checked>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">慢性腰痛史</label>
                            <input type="radio" name="2-7-0" value="0" title="有">
                            <input type="radio" name="2-7-0" value="1" title="无" checked>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">活动后腰腿痛</label>
                            <input type="radio" name="2-8-0" value="0" title="有">
                            <input type="radio" name="2-8-0" value="1" title="无" checked>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">下腹或大腿前侧痛</label>
                            <input type="radio" name="2-9-0" value="0" title="有">
                            <input type="radio" name="2-9-0" value="1" title="无" checked>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">腹压增高疼痛</label>
                            <input type="radio" name="2-10-0" value="0" title="有">
                            <input type="radio" name="2-10-0" value="1" title="无" checked>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">跛行</label>
                            <input type="radio" name="2-11-0" value="0" title="有">
                            <input type="radio" name="2-11-0" value="1" title="无" checked>
                            <input type="radio" name="2-11-0" value="2" title="间歇性跛行">
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">腰痛及放射痛</label>
                            <div class="ares-row">
                                <label class="ares-col-12">性质</label>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="radio" name="2-12-0" value="0" title="刺痛">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="radio" name="2-12-0" value="1" title="烧灼样痛">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="radio" name="2-12-0" value="2" title="刀割样痛">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="radio" name="2-12-0" value="3" title="其它">
                                </div>
                            </div>
                            <textarea name="2-12-0-text" placeholder="请输入腰痛及放射痛性质其它补充说明" class="layui-textarea"></textarea>
                            <div class="layui-input-block">
                                <input type="checkbox" lay-skin="primary" name="2-13-0" title="伴麻、胀感">
                            </div>
                            <div class="ares-row">
                                <label class="ares-col-12">部位</label>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" name="2-14-0" lay-skin="primary" value="0" title="左臀部">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" name="2-14-1" lay-skin="primary" value="1" title="左大腿后侧">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" name="2-14-2" lay-skin="primary" value="2" title="左小腿前外侧">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" name="2-14-3" lay-skin="primary" value="3" title="左足背">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" name="2-14-4" lay-skin="primary" value="4" title="左拇指">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" name="2-14-5" lay-skin="primary" value="5" title="左小腿后外侧">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" name="2-14-6" lay-skin="primary" value="6" title="左足跟">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" name="2-14-7" lay-skin="primary" value="7" title="左足背外侧">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" name="2-14-8" lay-skin="primary" value="8" title="右臀部">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" name="2-14-9" lay-skin="primary" value="9" title="右大腿后外侧">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" name="2-14-10" lay-skin="primary" value="10" title="右小腿前外侧">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" name="2-14-11" lay-skin="primary" value="11" title="右足背">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" name="2-14-12" lay-skin="primary" value="12" title="右拇指">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" name="2-14-13" lay-skin="primary" value="13" title="右小腿后外侧">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" name="2-14-14" lay-skin="primary" value="14" title="右足跟">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" name="2-14-15" lay-skin="primary" value="15" title="右足背外侧">
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">专科检查</label>
                        <div class="layui-input-block">
                            <label>生理弯曲</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-15-0" value="0" title="正常">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-15-0" value="1" title="减小">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-15-0" value="2" title="消失">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-15-0" value="3" title="后凸">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-15-0" value="4" title="其它">
                                </div>
                            </div>
                            <textarea name="2-15-0-text" placeholder="请输入生理弯曲其它补充内容" class="layui-textarea"></textarea>
                        </div>
                        <div class="layui-input-block">
                            <label>腰肌痉挛</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-16-0" value="0" title="左侧">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-16-0" value="1" title="右侧">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-16-0" value="2" title="双侧">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-16-0" value="3" title="无">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>脊柱侧弯</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-17-0" value="0" title="左">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-17-0" value="1" title="右">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-17-0" value="2" title="无">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>腰椎棘旁压痛</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-18-0" value="0" title="+">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-18-0" value="1" title="-">
                                </div>
                            </div>
                            <textarea name="2-18-0-text" placeholder="请输入节段" class="layui-textarea"></textarea>
                        </div>
                        <div class="layui-input-block">
                            <label>挺腹试验</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-19-0" value="0" title="+">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-19-0" value="1" title="-">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-19-0" value="2" title="±">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>屈颈试验</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-20-0" value="0" title="+">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-20-0" value="1" title="-">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-20-0" value="2" title="±">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>后伸试验</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-21-0" value="0" title="+">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-21-0" value="1" title="-">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-21-0" value="2" title="±">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>侧‘4’字试验(左)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-22-0" value="0" title="+">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-22-0" value="1" title="-">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-22-0" value="2" title="±">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>‘4’字试验(右)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-23-0" value="0" title="+">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-23-0" value="1" title="-">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-23-0" value="2" title="±">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>直腿抬高试验(左)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-24-0" value="0" title="+">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-24-0" value="1" title="-">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>直腿抬高试验(右)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-25-0" value="0" title="+">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-25-0" value="1" title="-">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>下肢针刺觉减退(左)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-26-0" value="0" title="+">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-26-0" value="1" title="-">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>下肢针刺觉减退(右)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-27-0" value="0" title="+">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-27-0" value="1" title="-">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>左下肢腱反射(膝腱)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-28-0" value="0" title="亢进">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-28-0" value="1" title="减弱">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-28-0" value="2" title="正常">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>左下肢腱反射(跟腱)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-29-0" value="0" title="亢进">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-29-0" value="1" title="减弱">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-29-0" value="2" title="正常">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>右下肢腱反射(膝腱)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-30-0" value="0" title="亢进">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-30-0" value="1" title="减弱">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-30-0" value="2" title="正常">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>右下肢腱反射(跟腱)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-31-0" value="0" title="亢进">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-31-0" value="1" title="减弱">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-31-0" value="2" title="正常">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>踇趾肌力</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">背屈</label>
                                    <div class="layui-inline">
                                        <select name="2-32-0">
                                            <option value="">请选择</option>
                                            <option value="1">0级</option>
                                            <option value="2">1级</option>
                                            <option value="3">2级</option>
                                            <option value="4">3级</option>
                                            <option value="5">4级</option>
                                            <option value="6">5级</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">跖屈</label>
                                    <div class="layui-inline">
                                        <select name="2-33-0">
                                            <option value="">请选择</option>
                                            <option value="1">0级</option>
                                            <option value="2">1级</option>
                                            <option value="3">2级</option>
                                            <option value="4">3级</option>
                                            <option value="5">4级</option>
                                            <option value="6">5级</option>
                                        </select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">既往病史及治疗情况</label>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">腰部外伤史</label>
                            <input type="radio" name="2-34-0" value="0" title="无">
                            <input type="radio" name="2-34-0" value="1" title="有">
                            <div class="ares-row">
                                <div class="ares-col-6">
                                    <label>时间</label>
                                    <textarea name="2-34-0-date" placeholder="" class="layui-textarea"></textarea>
                                </div>
                                <div class="ares-col-6">
                                    <label>治疗</label>
                                    <textarea name="2-34-0-text" placeholder="" class="layui-textarea"></textarea>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>所从事工作性质</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-35-0" value="0" title="久坐">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-35-0" value="1" title="久立">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-35-0" value="2" title="体力工作">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-35-0" value="3" title="一般">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>姿势不良</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-36-0" value="0" title="无">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-36-0" value="1" title="有">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>寒冷刺激</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-37-0" value="0" title="无">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="2-37-0" value="1" title="有">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">结核病史</label>
                            <input type="radio" name="2-38-0" value="0" title="无">
                            <input type="radio" name="2-38-0" value="1" title="有">
                            <div class="ares-row">
                                <div class="ares-col-6">
                                    <label>时间</label>
                                    <textarea name="2-38-0-date" placeholder="" class="layui-textarea"></textarea>
                                </div>
                                <div class="ares-col-6">
                                    <label>治疗</label>
                                    <textarea name="2-38-0-text" placeholder="" class="layui-textarea"></textarea>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">肿瘤病史</label>
                            <input type="radio" name="2-39-0" value="0" title="无">
                            <input type="radio" name="2-39-0" value="1" title="有">
                            <div class="ares-row">
                                <div class="ares-col-6">
                                    <label>时间</label>
                                    <textarea name="2-39-0-date" placeholder="" class="layui-textarea"></textarea>
                                </div>
                                <div class="ares-col-6">
                                    <label>治疗</label>
                                    <textarea name="2-39-0-text" placeholder="" class="layui-textarea"></textarea>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">手术病史</label>
                            <input type="radio" name="2-40-0" value="0" title="无">
                            <input type="radio" name="2-40-0" value="1" title="有">
                            <div class="ares-row">
                                <div class="ares-col-6">
                                    <label>时间</label>
                                    <textarea name="2-40-0-date" placeholder="" class="layui-textarea"></textarea>
                                </div>
                                <div class="ares-col-6">
                                    <label>治疗</label>
                                    <textarea name="2-40-0-text" placeholder="" class="layui-textarea"></textarea>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">其它肌肉关节疼痛史</label>
                            <input type="radio" name="2-41-0" value="0" title="无">
                            <input type="radio" name="2-41-0" value="1" title="有">
                            <div class="ares-row">
                                <div class="ares-col-6">
                                    <label>时间</label>
                                    <textarea name="2-41-0-date" placeholder="" class="layui-textarea"></textarea>
                                </div>
                                <div class="ares-col-6">
                                    <label>治疗</label>
                                    <textarea name="2-41-0-text" placeholder="" class="layui-textarea"></textarea>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">其它既往病史</label>
                            <input type="radio" name="2-42-0" value="0" title="无">
                            <input type="radio" name="2-42-0" value="1" title="有">
                            <div class="ares-row">
                                <div class="ares-col-6">
                                    <label>时间</label>
                                    <textarea name="2-42-0-date" placeholder="" class="layui-textarea"></textarea>
                                </div>
                                <div class="ares-col-6">
                                    <label>治疗</label>
                                    <textarea name="2-42-0-text" placeholder="" class="layui-textarea"></textarea>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">临床诊断</label>
                        <div class="layui-inline">
                            <label class="inline-label">西医诊断</label>
                            <div class="layui-inline">
                                <select name="2-43-0">
                                    <option value="">请选择</option>
                                    <option value="1">腰肌劳损</option>
                                    <option value="2">腰三横突综合征</option>
                                    <option value="3">急性腰扭伤</option>
                                    <option value="4">腰背部筋膜炎</option>
                                    <option value="5">其它</option>
                                </select>
                            </div>
                        </div>
                        <div class="layui-inline">
                            <label class="inline-label">中医诊断</label>
                            <div class="layui-inline">
                                <select name="2-44-0">
                                    <option value="">请选择</option>
                                    <option value="1">寒湿型</option>
                                    <option value="2">瘀血型</option>
                                    <option value="3">湿热型</option>
                                    <option value="4">肾虚型(肾阴虚、肾阳虚)</option>
                                </select>
                            </div>
                        </div>
                        <div class="layui-inline">
                            <label class="inline-label">功能诊断</label>
                            <div class="layui-inline">
                                <select name="2-45-0" id="print_2_45_0">
                                    <option value="">请选择</option>
                                    <option value="1">腰部疼痛</option>
                                    <option value="2">腰部活动受限</option>
                                    <option value="3">躯干肌力下降</option>
                                    <option value="4">躯干稳定性下降</option>
                                    <option value="5">姿势维持能力减退</option>
                                    <option value="6">平衡功能减退</option>
                                    <option value="7">ADL降低</option>
                                </select>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-label">补充说明</label>
                            <textarea name="2-46-0" placeholder="" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <div class="layui-input-block">
                            <button class="layui-btn layui-hide" data-type="3" lay-submit lay-filter="submit-osphyalgia">提交表单</button>
                        </div>
                    </div>
                </form>
            </div>
            <div id="knee-joint" class="layui-tab-item">
                <form class="ares-p layui-form" lay-filter="knee-joint">
                    <div class="layui-form-item">
                        <label class="layui-form-label"><span class="ares-text-red">*</span>主诉</label>
                        <div class="layui-input-block">
                            <textarea name="3-0-0" lay-verify="required" placeholder="请输入主诉" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label"><span class="ares-text-red">*</span>现病史</label>
                        <div class="layui-input-block">
                            <textarea name="3-1-0" lay-verify="required" placeholder="请输入现病史" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">专科检查</label>
                        <div class="layui-input-block">
                            <label>外伤史</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="3-2-0" value="0" title="无">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="3-2-0" value="1" title="有">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>慢性膝部疼痛史</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="3-3-0" value="0" title="无">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="3-3-0" value="1" title="有">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>活动后膝部痛</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="3-4-0" value="0" title="无">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="3-4-0" value="1" title="有">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>压痛点</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="checkbox" lay-skin="primary" name="3-5-0" title="内膝眼">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="checkbox" lay-skin="primary" name="3-5-1" title="内侧间隙">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="checkbox" lay-skin="primary" name="3-5-2" title="内侧副韧带">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="checkbox" lay-skin="primary" name="3-5-3" title="髌骨下方">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="checkbox" lay-skin="primary" name="3-5-4" title="外膝眼">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="checkbox" lay-skin="primary" name="3-5-5" title="外侧间隙">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="checkbox" lay-skin="primary" name="3-5-6" title="外侧副韧带">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="checkbox" lay-skin="primary" name="3-5-7" title="髌骨周围">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>膝关节活动度</label>
                            <div class="ares-row">
                                <div class="ares-col-6">
                                    <label class="inline-label">左屈曲</label>
                                    <input type="number" name="3-6-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                    <label class="inline-label">度</label>
                                </div>
                                <div class="ares-col-6">
                                    <label class="inline-label">右屈曲</label>
                                    <input type="number" name="3-7-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                    <label class="inline-label">度</label>
                                </div>
                                <div class="ares-col-6">
                                    <label class="inline-label">左伸展</label>
                                    <input type="number" name="3-8-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                    <label class="inline-label">度</label>
                                </div>
                                <div class="ares-col-6">
                                    <label class="inline-label">右伸展</label>
                                    <input type="number" name="3-9-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                    <label class="inline-label">度</label>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>髌骨活动度</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="3-10-0" value="0" title="正常">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="3-10-0" value="1" title="左受限">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="3-10-0" value="2" title="右受限">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>肌力</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">屈曲</label>
                                    <div class="layui-inline">
                                        <select name="3-11-0">
                                            <option value="">请选择</option>
                                            <option value="1">0级</option>
                                            <option value="2">1级</option>
                                            <option value="3">2级</option>
                                            <option value="4">3级</option>
                                            <option value="5">4级</option>
                                            <option value="6">5级</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">伸展</label>
                                    <div class="layui-inline">
                                        <select name="3-12-0">
                                            <option value="">请选择</option>
                                            <option value="1">0级</option>
                                            <option value="2">1级</option>
                                            <option value="3">2级</option>
                                            <option value="4">3级</option>
                                            <option value="5">4级</option>
                                            <option value="6">5级</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">膝跳反射</label>
                                    <div class="layui-inline">
                                        <select name="3-13-0">
                                            <option value="">请选择</option>
                                            <option value="1">(-)</option>
                                            <option value="2">(+)</option>
                                            <option value="3">(++)</option>
                                            <option value="4">(+++)</option>
                                            <option value="5">(++++)</option>
                                        </select>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>特殊检查</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">髌骨研磨试验</label>
                                    <div class="layui-inline">
                                        <select name="3-14-0">
                                            <option value="">请选择</option>
                                            <option value="1">(+)</option>
                                            <option value="2">(-)</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">浮髌试验</label>
                                    <div class="layui-inline">
                                        <select name="3-15-0">
                                            <option value="">请选择</option>
                                            <option value="1">(+)</option>
                                            <option value="2">(-)</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">(内侧)侧向挤压</label>
                                    <div class="layui-inline">
                                        <select name="3-16-0">
                                            <option value="">请选择</option>
                                            <option value="1">(+)</option>
                                            <option value="2">(-)</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">(外侧)侧向挤压</label>
                                    <div class="layui-inline">
                                        <select name="3-17-0">
                                            <option value="">请选择</option>
                                            <option value="1">(+)</option>
                                            <option value="2">(-)</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">麦氏征(内侧)</label>
                                    <div class="layui-inline">
                                        <select name="3-18-0">
                                            <option value="">请选择</option>
                                            <option value="1">(+)</option>
                                            <option value="2">(-)</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">麦氏征(外侧)</label>
                                    <div class="layui-inline">
                                        <select name="3-19-0">
                                            <option value="">请选择</option>
                                            <option value="1">(+)</option>
                                            <option value="2">(-)</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">前抽屉试验</label>
                                    <div class="layui-inline">
                                        <select name="3-20-0">
                                            <option value="">请选择</option>
                                            <option value="1">(+)</option>
                                            <option value="2">(-)</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">后抽屉试验</label>
                                    <div class="layui-inline">
                                        <select name="3-21-0">
                                            <option value="">请选择</option>
                                            <option value="1">(+)</option>
                                            <option value="2">(-)</option>
                                        </select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">既往病史及治疗情况</label>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">膝关节外伤史</label>
                            <input type="radio" name="3-22-0" value="0" title="无">
                            <input type="radio" name="3-22-0" value="1" title="有">
                            <div class="ares-row">
                                <div class="ares-col-6">
                                    <label>时间</label>
                                    <textarea name="3-22-0-date" placeholder="" class="layui-textarea"></textarea>
                                </div>
                                <div class="ares-col-6">
                                    <label>治疗</label>
                                    <textarea name="3-22-0-text" placeholder="" class="layui-textarea"></textarea>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>所从事工作性质</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="3-23-0" value="0" title="久坐">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="3-23-0" value="1" title="久立">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="3-23-0" value="2" title="体力工作">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="3-23-0" value="3" title="一般">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>寒冷刺激</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="3-24-0" value="0" title="无">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <input type="radio" name="3-24-0" value="1" title="有">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">结核病史</label>
                            <input type="radio" name="3-25-0" value="0" title="无">
                            <input type="radio" name="3-25-0" value="1" title="有">
                            <div class="ares-row">
                                <div class="ares-col-6">
                                    <label>时间</label>
                                    <textarea name="3-25-0-date" placeholder="" class="layui-textarea"></textarea>
                                </div>
                                <div class="ares-col-6">
                                    <label>治疗</label>
                                    <textarea name="3-25-0-text" placeholder="" class="layui-textarea"></textarea>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">肿瘤病史</label>
                            <input type="radio" name="3-26-0" value="0" title="无">
                            <input type="radio" name="3-26-0" value="1" title="有">
                            <div class="ares-row">
                                <div class="ares-col-6">
                                    <label>时间</label>
                                    <textarea name="3-26-0-date" placeholder="" class="layui-textarea"></textarea>
                                </div>
                                <div class="ares-col-6">
                                    <label>治疗</label>
                                    <textarea name="3-26-0-text" placeholder="" class="layui-textarea"></textarea>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">手术病史</label>
                            <input type="radio" name="3-27-0" value="0" title="无">
                            <input type="radio" name="3-27-0" value="1" title="有">
                            <div class="ares-row">
                                <div class="ares-col-6">
                                    <label>时间</label>
                                    <textarea name="3-27-0-date" placeholder="" class="layui-textarea"></textarea>
                                </div>
                                <div class="ares-col-6">
                                    <label>治疗</label>
                                    <textarea name="3-27-0-text" placeholder="" class="layui-textarea"></textarea>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">其它肌肉关节疼痛史</label>
                            <input type="radio" name="3-28-0" value="0" title="无">
                            <input type="radio" name="3-28-0" value="1" title="有">
                            <div class="ares-row">
                                <div class="ares-col-6">
                                    <label>时间</label>
                                    <textarea name="3-28-0-date" placeholder="" class="layui-textarea"></textarea>
                                </div>
                                <div class="ares-col-6">
                                    <label>治疗</label>
                                    <textarea name="3-28-0-text" placeholder="" class="layui-textarea"></textarea>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">其它既往病史</label>
                            <input type="radio" name="3-29-0" value="0" title="无">
                            <input type="radio" name="3-29-0" value="1" title="有">
                            <div class="ares-row">
                                <div class="ares-col-6">
                                    <label>时间</label>
                                    <textarea name="3-29-0-date" placeholder="" class="layui-textarea"></textarea>
                                </div>
                                <div class="ares-col-6">
                                    <label>治疗</label>
                                    <textarea name="3-29-0-text" placeholder="" class="layui-textarea"></textarea>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">临床诊断</label>
                        <div class="layui-inline">
                            <label class="inline-label">西医诊断</label>
                            <div class="layui-inline">
                                <select name="3-30-0">
                                    <option>请选择</option>
                                    <option>膝关节退行性骨关节炎</option>
                                    <option>膝关节滑膜炎</option>
                                    <option>风湿性关节炎</option>
                                    <option>股骨骨折术后</option>
                                    <option>胫骨骨折术后</option>
                                    <option>髌骨骨折术后</option>
                                    <option>膝关节创伤或韧带修复术后</option>
                                    <option>膝关节置换术后</option>
                                    <option>其它</option>
                                </select>
                            </div>
                        </div>
                        <div class="layui-inline">
                            <label class="inline-label">中医诊断</label>
                            <div class="layui-inline">
                                <select name="3-31-0">
                                    <option>请选择</option>
                                    <option>骨痹(肾虚髓亏)</option>
                                    <option>骨痹(阳虚寒凝)</option>
                                    <option>骨痹(瘀血阻滞)</option>
                                </select>
                            </div>
                        </div>
                        <div class="layui-inline">
                            <label class="inline-label">功能诊断</label>
                            <div class="layui-inline">
                                <select name="3-32-0">
                                    <option>请选择</option>
                                    <option>肌力障碍</option>
                                    <option>活动障碍</option>
                                    <option>疼痛障碍</option>
                                    <option>功能障碍</option>
                                </select>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-label">补充说明</label>
                            <textarea name="3-33-0" placeholder="" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <div class="layui-input-block">
                            <button class="layui-btn layui-hide" data-type="4" lay-submit lay-filter="submit-knee-joint">提交表单</button>
                        </div>
                    </div>
                </form>
            </div>
            <div id="spine-injure" class="layui-tab-item">
                <form class="ares-p layui-form" lay-filter="spine-injure">
                    <div class="layui-form-item">
                        <label class="layui-form-label"><span class="ares-text-red">*</span>主诉</label>
                        <div class="layui-input-block">
                            <textarea name="5-0-0" lay-verify="required" placeholder="请输入主诉" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label"><span class="ares-text-red">*</span>现病史</label>
                        <div class="layui-input-block">
                            <textarea name="5-1-0" lay-verify="required" placeholder="请输入现病史" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>C2</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>枕骨粗隆</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-2-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-2-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-2-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-2-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>C3</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>锁骨上窝</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-3-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-3-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-3-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-3-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>C4</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>肩锁关节顶部</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-4-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-4-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-4-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-4-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>C5</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>肘前窝外侧面</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-5-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-5-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-5-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-5-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>运动检查关键肌群(<b>屈肘肌</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-5-4"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-5-5"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>C6</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>拇指</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-6-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-6-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-6-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-6-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>运动检查关键肌群(<b>伸腕肌</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-6-4"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-6-5"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>C7</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>中指</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-7-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-7-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-7-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-7-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>运动检查关键肌群(<b>伸肘肌</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-7-4"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-7-5"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>C8</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>小指</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-8-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-8-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-8-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-8-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>运动检查关键肌群(<b>中指屈指肌</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-8-4"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-8-5"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>T1</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>肘前窝尺侧面</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-9-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-9-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-9-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-9-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>运动检查关键肌群(<b>小指展肌</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-9-4"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-9-5"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>T2</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>掖窝</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-10-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-10-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-10-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-10-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>T3</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>第3肋间</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-11-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-11-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-11-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-11-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>T4</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>第4肋间（乳头）</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-12-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-12-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-12-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-12-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>T5</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>第5肋间</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-13-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-13-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-13-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-13-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>T6</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>第6肋间（剑突）</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-14-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-14-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-14-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-14-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>T7</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>第7肋间</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-15-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-15-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-15-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-15-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>T8</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>第8肋间（肋弓下缘）</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-16-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-16-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-16-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-16-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>T9</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>第9肋间</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-17-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-17-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-17-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-17-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>T10</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>第10肋间（脐）</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-18-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-18-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-18-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-18-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>T11</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>第11肋间</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-19-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-19-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-19-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-19-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>T12</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>腹股沟韧带中部</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-20-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-20-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-20-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-20-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>L1</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>T12与L2间的上1/2</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-21-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-21-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-21-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-21-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>L2</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>大腿前中部</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-22-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-22-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-22-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-22-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>运动检查关键肌群(<b>屈髋肌</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-22-4"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-22-5"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>L3</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>股骨内侧髁</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-23-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-23-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-23-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-23-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>运动检查关键肌群(<b>伸膝肌</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-23-4"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-23-5"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>L4</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>内踝</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-24-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-24-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-24-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-24-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>运动检查关键肌群(<b>踝背伸肌</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-24-4"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-24-5"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>L5</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>第3跖骨颈背侧</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-25-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-25-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-25-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-25-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>运动检查关键肌群(<b>趾伸肌</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-25-4"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-25-5"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>S1</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>足跟外侧</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-26-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-26-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-26-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-26-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>运动检查关键肌群(<b>踝跖屈肌</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-26-4"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右</label>
                                    <div class="layui-inline">
                                        <select class="myodynamia-level-select" lay-filter="myodynamia-level-select" name="5-26-5"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>S2</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>腘窝中点</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-27-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-27-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-27-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-27-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>S3</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>坐骨结节</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-28-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-28-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-28-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-28-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">神经节段(<b>S45</b>)</label>
                        <div class="layui-input-block">
                            <label>感觉检查关键点(<b>肛门周围</b>)</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-29-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">左触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-29-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右痛觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-29-2"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">右触觉</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-29-3"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">括约肌功能及反射检查</label>
                        <div class="layui-input-block">
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">肛门指诊</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-30-0"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">肛门反射</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-30-1"></select>
                                    </div>
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-3">
                                    <label class="inline-label">尿道球海绵体反射</label>
                                    <div class="layui-inline">
                                        <select class="sense-level-select" lay-filter="sense-level-select" name="5-30-2"></select>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label"><span class="ares-text-red">*</span>损害程度分级</label>
                        <div class="layui-input-block">
                            <input type="radio" name="5-31-0" value="A" title="A、 完全性损害，骶区无任何感觉和运动功能保留" lay-verify="requiredRaido" lay-verify-label="损害程度分级">
                        </div>
                        <div class="layui-input-block">
                            <input type="radio" name="5-31-0" value="B" title="B、 不完全性损害，在神经平面以下包括骶段（S4,5）存在感觉功能但无运动功能">
                        </div>
                        <div class="layui-input-block">
                            <input type="radio" name="5-31-0" value="C" title="C、 不完全性损害，在神经平面以下存在运动功能，50%以上关键肌的肌力小于3级">
                        </div>
                        <div class="layui-input-block">
                            <input type="radio" name="5-31-0" value="D" title="D、 不完全性损害，在神经平面以下存在运动功能，并且50%以上关键肌的肌力大或等于3级">
                        </div>
                        <div class="layui-input-block">
                            <input type="radio" name="5-31-0" value="E" title="E、 感觉和运动功能正常">
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label"><span class="ares-text-red">*</span>修订Ashworth分级评价标准</label>
                        <div class="layui-input-block">
                            <input type="radio" name="5-32-0" value="A" title="0级：无肌张力增加" lay-verify="requiredRaido" lay-verify-label="修订Ashworth分级评价标准">
                        </div>
                        <div class="layui-input-block">
                            <input type="radio" name="5-32-0" value="A" title="Ⅰ级：肌张力轻度增加，受累部分被动屈伸时，在活动范围之末时出现最小阻力或突然出现的卡住和放松">
                        </div>
                        <div class="layui-input-block">
                            <input type="radio" name="5-32-0" value="A" title="Ⅰ+级：肌张力稍增高，在关节活动范围50%之内出现突然卡住，然后在关节活动范围50%之后均呈现最小阻力">
                        </div>
                        <div class="layui-input-block">
                            <input type="radio" name="5-32-0" value="A" title="Ⅱ级：肌张力增加较明显，关节活动范围的大部分肌张力明显增加，但受累部分仍能较容易的被动活动">
                        </div>
                        <div class="layui-input-block">
                            <input type="radio" name="5-32-0" value="A" title="Ⅲ级：肌张力严重增高，被动活动困难">
                        </div>
                        <div class="layui-input-block">
                            <input type="radio" name="5-32-0" value="A" title="Ⅳ级：挛缩，受累部分被动屈伸时呈挛缩状态而不能动">
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label"><span class="ares-text-res">*</span>ADL评分(改良Barthel指数)</label>
                        <div class="layui-input-block">
                            <input type="number" name="5-33-0" autocomplete="off" lay-verify="required|number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                            <label class="inline-label">分</label>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">临床诊断</label>
                        <div class="layui-inline">
                            <label class="inline-label">西医诊断</label>
                            <div class="layui-inline">
                                <select name="5-34-0">
                                    <option>请选择</option>
                                    <option>外伤性脊髓损伤</option>
                                    <option>脊髓动脉瘤</option>
                                    <option>脊髓肿瘤</option>
                                    <option>脊髓炎</option>
                                    <option>视神经脊髓炎</option>
                                    <option>脊髓侧索硬化</option>
                                    <option>多发性硬化</option>
                                </select>
                            </div>
                        </div>
                        <div class="layui-inline">
                            <label class="inline-label">中医诊断</label>
                            <div class="layui-inline">
                                <select name="5-35-0">
                                    <option>请选择</option>
                                    <option>痿证</option>
                                </select>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-label">补充说明</label>
                            <textarea name="5-36-0" placeholder="" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <hr>
                    <div class="ares-mb-lg">
                        <span>总感觉评分: <b id="total-sense-score">0</b></span>
                        <span class="ares-mx-lg">总运动评分: <b id="total-myodynamia-score">0</b></span>
                        <span>总评分: <b id="total-score">0</b></span>
                    </div>

                    <div class="layui-form-item">
                        <div class="layui-input-block">
                            <button class="layui-btn layui-hide" data-type="5" lay-submit lay-filter="submit-spine-injure">提交表单</button>
                        </div>
                    </div>
                </form>
            </div>
            <div id="cerebral-palsy" class="layui-tab-item">
                <form class="ares-p layui-form" lay-filter="cerebral-palsy">
                    <div class="layui-form-item">
                        <label class="layui-form-label"><span class="ares-text-red">*</span>主诉</label>
                        <div class="layui-input-block">
                            <textarea name="0-0-0" lay-verify="required" lay-verType="tips" placeholder="请输入主诉" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label"><span class="ares-text-red">*</span>现病史</label>
                        <div class="layui-input-block">
                            <textarea name="0-1-0" lay-verify="required" lay-verType="tips" placeholder="请输入现病史" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">出生史</label>
                        <div class="layui-input-block ares-row">
                            <div class="ares-col-sm-12 ares-col-md-6">
                                <label class="prefix-label inline-label">第</label>
                                <input type="number" name="0-2-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">胎</label>
                            </div>
                            <div class="ares-col-sm-12 ares-col-md-6">
                                <label class="prefix-label inline-label">第</label>
                                <input type="number" name="0-3-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">产</label>
                            </div>
                            <div class="ares-col-sm-12 ares-col-md-6">
                                <label class="prefix-label inline-label">胎龄</label>
                                <input type="number" name="0-4-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">周</label>
                            </div>
                            <div class="ares-col-sm-12 ares-col-md-6">
                                <label class="prefix-label inline-label">胎龄</label>
                                <input type="number" name="0-4-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">周</label>
                                <input type="number" name="0-5-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">天</label>
                            </div>
                            <div class="ares-col-sm-12 ares-col-md-6">
                                <label class="prefix-label inline-label">出生体重</label>
                                <input type="number" name="0-6-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">kg</label>
                            </div>
                            <div class="ares-col-sm-12 ares-col-md-6">
                                <label class="prefix-label inline-label"></label>
                                <input type="radio" name="0-7-0" value="0" title="顺产" checked>
                                <input type="radio" name="0-7-0" value="1" title="剖腹产">
                            </div>
                            <div class="ares-col-sm-12 ares-col-md-6">
                                <label class="prefix-label inline-label">Apgar评分</label>
                                <input type="number" name="0-8-0" autocomplete="off" lay-verify="number|range" lay-verType="tips" min="0" max="10" class="layui-input inline-input">
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>孕期</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-9-0" title="母患疾病">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-9-1" title="妊娠中毒">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-9-2" title="低血糖">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-9-3" title="胎盘脐带羊水异常">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-9-4" title="病毒感染">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-9-5" title="缺氧">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-9-6" title="药物影响">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-9-7" title="遗传性神经疾病">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>出生时</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-10-0" title="创伤">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-10-1" title="窒息">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-10-2" title="早产">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-10-3" title="足月小样儿">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-10-4" title="巨大儿">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-10-5" title="低体重儿">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-10-6" title="多胎">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-10-7" title="异常分娩">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-10-8" title="过期产">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>出生后</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-11-0" title="窒息">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-11-1" title="脑出血">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-11-2" title="黄疸">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-11-3" title="颅内感染">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-11-4" title="缺氧缺血性脑病">
                                </div>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">新生儿期疾病</label>
                        <div class="layui-input-block">
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-12-0" title="缺血缺氧性脑病">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-12-1" title="颅内出血">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-12-2" title="核黄疸">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-12-3" title="其它">
                                </div>
                            </div>
                            <textarea name="0-12-3-text" placeholder="请输入新生儿期疾病其它补充内容" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">母孕产史</label>
                        <div class="layui-input-block">
                            <div class="layui-inline">
                                <label class="inline-label">孕龄</label>
                                <input type="number" name="0-13-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">岁</label>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>不良孕产史</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="radio" name="0-14-0" value="0" title="无">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="radio" name="0-14-0" value="1" title="胎儿停育">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="radio" name="0-14-0" value="2" title="胎儿畸形">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="radio" name="0-14-0" value="3" title="死胎">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="radio" name="0-14-0" value="4" title="死产">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>孕期疾病</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="radio" name="0-15-0" value="0" title="糖尿病">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="radio" name="0-15-0" value="1" title="低血糖">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="radio" name="0-15-0" value="2" title="贫血">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="radio" name="0-15-0" value="3" title="高血压">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="radio" name="0-15-0" value="4" title="风疹">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="radio" name="0-15-0" value="5" title="其它">
                                </div>
                            </div>
                            <textarea name="0-15-0-text" placeholder="请输入孕期疾病其它补充内容" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">发育史</label>
                        <div class="ares-row">
                            <div class="ares-col-sm-6 ares-col-md-4">
                                <label class="inline-label">抬头</label>
                                <input type="number" name="0-16-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">月</label>
                            </div>
                            <div class="ares-col-sm-6 ares-col-md-4">
                                <label class="inline-label">翻身</label>
                                <input type="number" name="0-17-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">月</label>
                            </div>
                            <div class="ares-col-sm-6 ares-col-md-4">
                                <label class="inline-label">独坐</label>
                                <input type="number" name="0-18-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">月</label>
                            </div>
                            <div class="ares-col-sm-6 ares-col-md-4">
                                <label class="inline-label">四爬</label>
                                <input type="number" name="0-19-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">月</label>
                            </div>
                            <div class="ares-col-sm-6 ares-col-md-4">
                                <label class="inline-label">站立</label>
                                <input type="number" name="0-20-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">月</label>
                            </div>
                            <div class="ares-col-sm-6 ares-col-md-4">
                                <label class="inline-label">独走</label>
                                <input type="number" name="0-21-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                <label class="inline-label">月</label>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>语言能力</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-22-0" title="单词">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-22-1" title="短语">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-22-2" title="句子">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-22-3" title="口吃">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-22-4" title="流涎">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-22-5" title="其它">
                                </div>
                            </div>
                            <textarea name="0-22-5-text" placeholder="请输入语言能力其它补充内容" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">既往史</label>
                        <div class="layui-input-block">
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-23-0" title="骨折">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-23-1" title="脑外伤">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-23-2" title="抽搐">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-23-3" title="其它">
                                </div>
                            </div>
                            <textarea name="0-23-3-text" placeholder="请输入既往史其它补充内容" class="layui-textarea"></textarea>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">既往接受康复训练治疗情况</label>
                            <input type="radio" name="0-24-0" value="0" title="无" checked>
                            <input type="radio" name="0-24-0" value="1" title="有">
                            <textarea name="0-24-0-text" placeholder="请输入既往接受康复训练治疗情况" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">家族史</label>
                        <div class="layui-input-block">
                            <textarea name="0-25-0" placeholder="请输入家族史" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">体格检查</label>
                        <div class="layui-input-block">
                            <div class="ares-row">
                                <div class="ares-col-6">
                                    <label class="inline-label">头围</label>
                                    <input type="number" name="0-26-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                    <label class="inline-label">cm</label>
                                </div>
                                <div class="ares-col-6">
                                    <label class="inline-label">囟门前后径</label>
                                    <input type="number" name="0-27-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                    <label class="inline-label">X左右径</label>
                                    <input type="number" name="0-28-0" autocomplete="off" lay-verify="number|min" lay-verType="tips" min="0" class="layui-input inline-input">
                                    <label class="inline-label">cm²</label>
                                </div>
                                <div class="ares-col-6">
                                    <input type="checkbox" lay-skin="primary" name="0-29-0" title="视力低下">
                                    <input type="checkbox" lay-skin="primary" name="0-29-1" title="听力下降">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label">肌张力</label>
                            <input type="radio" name="0-30-0" value="0" title="高">
                            <input type="radio" name="0-30-0" value="1" title="低">
                            <input type="radio" name="0-30-0" value="2" title="轻">
                            <input type="radio" name="0-30-0" value="3" title="中">
                            <input type="radio" name="0-30-0" value="4" title="重">
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-label">改良Ashworth</label>
                            <div class="layui-inline">
                                <select name="0-31-0">
                                    <option value="">请选择</option>
                                    <option value="1">0级</option>
                                    <option value="2">1级</option>
                                    <option value="3">1+级</option>
                                    <option value="4">2级</option>
                                    <option value="5">3级</option>
                                    <option value="6">4级</option>
                                </select>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>肌肉结构</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-32-0" title="肥大">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-32-1" title="萎缩">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-32-2" title="短缩">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-32-3" title="挛缩">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label>异常姿势</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-33-0" title="尖足">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-33-1" title="剪刀步态">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-33-2" title="马蹄内翻">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-33-3" title="足外翻">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-33-4" title="蹲伏步态">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-33-5" title="膝内旋">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-33-6" title="膝内翻">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-33-7" title="膝外翻">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-33-8" title="ATNR">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-33-9" title="STNR">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-33-10" title="TLR">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-33-11" title="其它">
                                </div>
                            </div>
                            <textarea name="0-33-11-text" placeholder="请输入异常姿势其它补充说明" class="layui-textarea"></textarea>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">反射检查</label>
                        <div class="layui-input-block">
                            <div class="layui-inline">
                                <label class="inline-label">膝腱反射</label>
                                <div class="layui-inline">
                                    <select name="0-34-0">
                                        <option value="">请选择</option>
                                        <option value="1">0级</option>
                                        <option value="2">1级</option>
                                        <option value="3">2级</option>
                                        <option value="4">3级</option>
                                        <option value="5">4级</option>
                                    </select>
                                </div>
                            </div>
                            <div class="layui-inline">
                                <label class="inline-label">巴彬斯基征</label>
                                <div class="layui-inline">
                                    <select name="0-35-0">
                                        <option value="">请选择</option>
                                        <option value="1">阴性</option>
                                        <option value="2">阳性</option>
                                    </select>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-radio-label"><span class="ares-text-red">*</span>GMFCS运动功能评定</label>
                            <input type="radio" name="0-36-0" value="0" title="Ⅰ级" lay-verify="requiredRadio" lay-verify-label="GMFCS运动功能评定" checked>
                            <input type="radio" name="0-36-0" value="1" title="Ⅱ级">
                            <input type="radio" name="0-36-0" value="2" title="Ⅲ级">
                            <input type="radio" name="0-36-0" value="3" title="Ⅳ级">
                            <input type="radio" name="0-36-0" value="4" title="Ⅴ级">
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <label class="layui-form-label">临床诊断</label>
                        <div class="layui-input-block">
                            <label class="inline-label">西医诊断</label>
                            <textarea name="0-37-0" placeholder="请输入西医诊断" class="layui-textarea"></textarea>
                            <div class="layui-inline ares-mt-sm">
                                <label class="inline-label">分型</label>
                                <div class="layui-inline">
                                    <select name="0-38-0">
                                        <option value="">请选择</option>
                                        <option value="1">痉挛型</option>
                                        <option value="2">四肢瘫</option>
                                        <option value="3">双瘫</option>
                                        <option value="4">偏瘫</option>
                                        <option value="5">不随意运动型</option>
                                        <option value="6">共济失调型</option>
                                        <option value="7">混合型</option>
                                    </select>
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-label">中医诊断</label>
                            <div>
                                <input type="checkbox" lay-skin="primary" name="0-39-0" title="五迟、五软">
                                <input type="checkbox" lay-skin="primary" name="0-39-1" title="五硬">
                                <input type="checkbox" lay-skin="primary" name="0-39-2" title="其它">
                                <textarea name="0-39-2-text" placeholder="请输入中医诊断其它补充说明" class="layui-textarea"></textarea>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-label">功能诊断</label>
                            <div class="ares-row">
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-40-0" title="智力功能(b117)障碍">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-40-1" title="语言接受障碍(b1760)">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-40-2" title="语言表达障碍(b1671)">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-40-3" title="听觉功能(b230) 障碍">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-40-4" title="吞咽(b5105)困难">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-40-5" title="视敏度功能(b2100)障碍">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-40-6" title="消化功能(b515)障碍">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-40-7" title="痛觉(b280)">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-40-8" title="多关节的运动(b7101)障碍">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-40-9" title="肌张力功能(b735)">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-40-10" title="肌张力低下">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-40-11" title="痉挛">
                                </div>
                                <div class="ares-col-sm-6 ares-col-md-4">
                                    <input type="checkbox" lay-skin="primary" name="0-40-12" title="强直">
                                </div>
                            </div>
                        </div>
                        <div class="layui-input-block">
                            <label class="inline-label">中医辨证</label>
                            <div>
                                <label class="inline-checkbox-label">主症</label>
                                <input type="checkbox" lay-skin="primary" name="0-41-0" title="软">
                                <input type="checkbox" lay-skin="primary" name="0-41-1" title="硬">
                                <input type="checkbox" lay-skin="primary" name="0-41-2" title="其它">
                                <textarea name="0-41-2-text" placeholder="请输入主症其它补充说明" class="layui-textarea"></textarea>
                            </div>
                            <div>
                                <label class="inline-checkbox-label">核心证候</label>
                                <input type="checkbox" lay-skin="primary" name="0-42-0" title="气虚血瘀">
                                <input type="checkbox" lay-skin="primary" name="0-42-1" title="肝肾不足">
                                <input type="checkbox" lay-skin="primary" name="0-42-2" title="脾气虚">
                                <input type="checkbox" lay-skin="primary" name="0-42-3" title="心脾两虚">
                                <input type="checkbox" lay-skin="primary" name="0-42-4" title="其它">
                                <textarea name="0-42-4-text" placeholder="请输入主症其它补充说明" class="layui-textarea"></textarea>
                            </div>
                            <div>
                                <label class="inline-checkbox-label">体质辨证</label>
                                <input type="checkbox" lay-skin="primary" name="0-43-0" title="营卫不和">
                                <input type="checkbox" lay-skin="primary" name="0-43-1" title="心胆虚怯">
                                <input type="checkbox" lay-skin="primary" name="0-43-2" title="阴虚火旺">
                                <input type="checkbox" lay-skin="primary" name="0-43-3" title="其它">
                                <textarea name="0-43-3-text" placeholder="请输入体质辨证其它说明" class="layui-textarea"></textarea>
                            </div>
                        </div>
                    </div>
                    <div class="layui-form-item">
                        <div class="layui-input-block">
                            <button class="layui-btn layui-hide" data-type="1" lay-submit lay-filter="submit-cerebral-palsy">提交表单</button>
                        </div>
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>

</body>


<script type="text/javascript" src="../../plugins/layui/layui.js"></script>
<script type="text/javascript" src="../../aresExtends/config/layuiConfig.js"></script>
<script>
    var init;
    layui.use(['qs', 'form', 'utils', 'filters', 'mandyServices', 'commonServices', 'clinicServices'], function (qs, form, utils, filters, mandyServices, commonServices, clinicServices) {
        var isTherapist = utils.isTherapist(),
            element = layui.element,
            latelyInfo = {};

        var emrId, clinicId, edit, readonly, isReferralHistory, transferId;

        var diseaseTypeId = 2;

        var spineInjureTotalSenseScore = 0, spineInjureTotalMyodynamiaScore = 0;


        /**
         * @author: ares
         * @date: 2021/3/26 9:24
         * @description: 初始化
         */
        init = function () {
            var localHash = location.hash,
                localSearch = location.search,
                queryStr = isTherapist ? localSearch.split('?')[1] : localHash.split('?')[1],
                routerQuery = queryStr ? qs.parse(queryStr) : {},
                routerParams = isTherapist ? routerQuery : top.layui.routers.params;
            emrId = routerParams.emrId;
            clinicId = routerQuery.clinicId;
            edit = !!routerQuery.edit;
            readonly = routerQuery.readonly;
            isReferralHistory = !!routerQuery.isReferralHistory;
            transferId = routerQuery.transferId;
            renderSpineInjureSenseLevelSelect();
            renderSpineInjureMyodynamiaLevelSelect();
            if (readonly != null && readonly == 'false') {
                if (edit) {
                    editClinic();
                } else {
                    selectDisease(diseaseTypeId);
                    getLatelyDiseaseInfo(emrId, diseaseTypeId);
                    $('button[lay-submit]').removeClass("layui-hide");
                }
            } else {
                $('button[lay-submit]').addClass("layui-hide");
                setReadonly();
                loadClinic();
            }
            getPatientInfo();
            form.render();
        }
        init();
        element.on('tab(type)', function (data) {
            diseaseTypeId = $(this).attr('lay-id');
            if (readonly != null && readonly == 'false' && !edit) {
                getLatelyDiseaseInfo(emrId, diseaseTypeId);
            }
        });
        form.on('select(patient-type)', function (data) {
            var $areaBedWrap = $('#area-bed-wrap'),
                type = data.value;
            if (type == 1) {
                form.val('base-info', {
                    wardArea: '',
                    bedNumber: '',
                })
                $areaBedWrap.addClass('layui-hide');
            } else {
                $areaBedWrap.removeClass('layui-hide');
            }
        })
        form.on('submit(submit-cerebral-palsy)', function (data) {
            submit($(data.elem), data.field)
            return false;
        })
        form.on('submit(submit-stroke)', function (data) {
            submit($(data.elem), data.field)
            return false;
        })
        form.on('submit(submit-osphyalgia)', function (data) {
            submit($(data.elem), data.field)
            return false;
        })
        form.on('submit(submit-knee-joint)', function (data) {
            submit($(data.elem), data.field)
            return false;
        })
        form.on('submit(submit-spine-injure)', function (data) {
            var diseaseInfo = data.field;
            diseaseInfo.totalSenseScore = spineInjureTotalSenseScore;
            diseaseInfo.totalMyodynamiaScore = spineInjureTotalMyodynamiaScore;
            submit($(data.elem), data.field)
            return false;
        })
        form.on('select(sense-level-select)', function () {
            var thisVal = $(this).attr('lay-value');
            thisVal = thisVal.length ? 1 * thisVal : 0;
            spineInjureTotalSenseScore += thisVal;
            $('#total-sense-score').text(spineInjureTotalSenseScore);
            $('#total-score').text(spineInjureTotalSenseScore + spineInjureTotalMyodynamiaScore);
        })
        form.on('select(myodynamia-level-select)', function () {
            var thisVal = $(this).attr('lay-value');
            thisVal = thisVal.length ? 1 * thisVal : 0;
            spineInjureTotalMyodynamiaScore += thisVal;
            $('#total-myodynamia-score').text(spineInjureTotalMyodynamiaScore);
            $('#total-score').text(spineInjureTotalSenseScore + spineInjureTotalMyodynamiaScore);
        })

        function setReadonly() {
            $("textarea").prop("disabled", true);
            $("input").prop("disabled", true);
            $("select").prop("disabled", true);
            form.render();
        }

        function selectDisease(val) {
            layui.element.tabChange('type', val);
            diseaseTypeId = val;
        }

        function setResult(diseaseInfo) {
            var result = {};
            if ($.type(diseaseInfo) == 'array') {
                $.each(diseaseInfo, function (index, item) {
                    result[item.name] = item.text || item.val || item.checked;
                })
            } else {
                result = diseaseInfo;
            }
            form.val('base-info', {
                patientType: result.patient_type || result['patient-type'],
                emrNumber: result.patientNumber || result.hospitalNumber,
                wardArea: result.wardArea,
                bedNumber: result.bedNumber
            })
            if (form.val('base-info').patientType != 1) $('#area-bed-wrap').removeClass('layui-hide');
            switch (diseaseTypeId) {
                case 1:
                    form.val('cerebral-palsy', result);
                    break;
                case 2:
                    form.val('stroke', result);
                    break;
                case 3:
                    form.val('osphyalgia', result);
                    break;
                case 4:
                    form.val('knee-joint', result);
                    break;
                case 5:
                    form.val('spine-injure', result);
                    $('#total-sense-score').text(result.totalSenseScore);
                    $('#total-myodynamia-score').text(result.totalMyodynamiaScore);
                    $('#total-score').text(1*result.totalSenseScore + 1*result.totalMyodynamiaScore);
                    break;
            }
        }

        function submit($btn, diseaseInfo) {
            var baseInfo = form.val('base-info'),
                type = baseInfo['patientType'],
                number = baseInfo['emrNumber'],
                wardArea = baseInfo['wardArea'],
                bedNumber = baseInfo['bedNumber'],
                data = {
                    patientType: type
                };
            if (!number) {
                utils.msgError('请填写患者编号');
                document.getElementById('emr-number').scrollIntoView({block: 'center'});
                return;
            }
            diseaseInfo['patient-type'] = type;
            if (type == 1) {
                diseaseInfo.patientNumber = number;
                data.patientNumber = number;
            } else {
                if (!wardArea) {
                    utils.msgError('请填写病区');
                    document.getElementById('ward-area').scrollIntoView({block: 'center'});
                    return;
                }
                if (!bedNumber) {
                    utils.msgError('请填写病床号');
                    document.getElementById('bed-number').scrollIntoView({block: 'center'});
                    return;
                }
                diseaseInfo.hospitalNumber = number;
                diseaseInfo.wardArea = wardArea;
                diseaseInfo.bedNumber = bedNumber;
                data.hospitalNumber = number;
                data.wardArea = wardArea;
                data.bedNumber = bedNumber;
            }
            data.diseaseInfo = JSON.stringify(diseaseInfo);
            if (edit) {
                updateClinicResult($btn, data)
            } else {
                submitClinicResult($btn, data)
            }
        }

        function submitClinicResult($btn, data) {
            $btn.prop('disabled', true).addClass('layui-btn-disabled')
            mandyServices.mandy_add_clinic(null, emrId, diseaseTypeId, data, null, null).then(function (res) {
                utils.msgSuccess(res.message)
                utils.closeCurrentSysTab()
                $btn.prop('disabled', false).removeClass('layui-btn-disabled')
            }).catch(function (err) {
                $btn.prop('disabled', false).removeClass('layui-btn-disabled')
            });
        }

        function updateClinicResult($btn, data) {
            $btn.prop('disabled', true).addClass('layui-btn-disabled')
            mandyServices.mandy_update_clinic("", clinicId, diseaseTypeId, data, "", "").then(function (res) {
                utils.msgSuccess(res.message)
                $btn.prop('disabled', false).removeClass('layui-btn-disabled')
            }).catch(function (err) {
                $btn.prop('disabled', false).removeClass('layui-btn-disabled')
            });
        }

        function loadClinic() {
            return mandyServices.mandy_get_clinic(clinicId, emrId, isReferralHistory).then(function (res) {
                var data = res.data;
                diseaseTypeId = data.disease.id;
                selectDisease(data.disease.id);
                setResult(JSON.parse(data.disease_info));
                return res;
            });
        }

        function editClinic() {
            loadClinic().then(function (res) {
                $('button[lay-submit][data-type="' + diseaseTypeId + '"]').removeClass("layui-hide");
            });
        }

        /**
         * @author: ares
         * @date: 2021/3/10 10:49
         * @description: 获取患者基本信息
         */
        function getPatientInfo() {
            commonServices.getEmrInfoService(emrId, transferId, null, $('.emr-info'));
        }

        /**
         * @author: ares
         * @date: 2021/4/7 9:55
         * @description: 查询最近一次病历信息
         * @param {string}emrId
         * @param {string}diseaseTypeId
         */
        function getLatelyDiseaseInfo(emrId, diseaseTypeId) {
            if (latelyInfo[diseaseTypeId]) return;
            clinicServices.getLatelyDiseaseInfoService(emrId, diseaseTypeId).then(function (res) {
                var data = res.data;
                if (!data || !data.diseaseInfo) return;
                latelyInfo[diseaseTypeId] = data;
                setResult(JSON.parse(data.diseaseInfo));
            })
        }

        /**
         * @author: ares
         * @date: 2021/4/7 12:45
         * @description: 渲染脊椎损伤感觉下拉列表
         */
        function renderSpineInjureSenseLevelSelect() {
            var list = [
                    {name: '请选择', value: ''},
                    {name: '缺失', value: 0},
                    {name: '障碍', value: 1},
                    {name: '正常', value: 2},
                ],
                $fragment = $(document.createDocumentFragment()),
                $select = $('.sense-level-select');
            $.each(list, function (index, item) {
                $fragment.append('<option value="' + item.value + '">' + item.name + '</option>');
            });
            $select.empty().append($fragment);
        }

        /**
         * @author: ares
         * @date: 2021/4/7 12:45
         * @description: 渲染脊椎损伤运动肌力下拉列表
         */
        function renderSpineInjureMyodynamiaLevelSelect() {
            var list = [
                    {name: '请选择', value: ''},
                    {name: '0级', value: 0},
                    {name: 'Ⅰ级', value: 1},
                    {name: 'Ⅱ级', value: 2},
                    {name: 'Ⅲ级', value: 3},
                    {name: 'Ⅳ级', value: 4},
                    {name: 'Ⅴ级', value: 5},
                ],
                $fragment = $(document.createDocumentFragment()),
                $select = $('.myodynamia-level-select');
            $.each(list, function (index, item) {
                $fragment.append('<option value="' + item.value + '">' + item.name + '</option>');
            });
            $select.empty().append($fragment);
        }


    })
</script>

</html>